Beat Cancer? Exercise is Even More Important for You

By Lisa Stuebing - Fall, 2017

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“You wouldn’t know it to see me, but I am a beast,” says Vicky Grams, a 12-year survivor of breast cancer. She credits her newfound love of life and exercise to her support group and her oncologist, the indefatigable Dr. Julie Gralow, director of breast medical oncology at Seattle Cancer Care Alliance and one of the original founders of Team Survivor Northwest.

Exhausted after cancer treatment, exercise was the last thing on Grams’ mind, but Gralow encouraged her again and again to join in the playful activities at Team Survivor. Then one day, Grams walked by a mirror and thought, “This is not how I am going to spend the rest of my life.” The cancer and treatment had robbed her of her “I-can-do-anything” landscaper’s physique. She was 70 pounds heavier and her complexion was pale.

What she saw did not jibe with her self-image, so Grams immediately decided to step a mile-and-a-half outside of her comfort zone to enroll in a dance class at Team Survivor Northwest. Pumped by the fun, she was inspired to do even more. Grams surprised herself by climbing Mt. Adams, and she is now certified to lead MixxedFit group exercise classes for sister survivors. “I feel fortunate to be here. I exercise because I want to, not because I have to,” she says. “It is how I pay homage to my friends who did not survive.”

Getting the team together

In 1995, shortly after completing her oncology fellowship, Gralow became concerned about the long-term health of her patients. Hearing colleagues advise patients to take it easy after treatment, she found research that there was no supporting evidence that rest is better than exercise for cancer survivors. Her patients had beaten cancer, but they were putting themselves at risk for heart disease and osteoporosis.

Gralow soon found two kindred spirits to recruit cancer survivors to participate in the local Danskin Triathlon, which was an event engineered to raise funds for cancer research. Exercise trainer Lisa Talbot and renowned triathlete Sally Edwards were on their way to a race in Austin, Texas, when they realized that they were not doing anything for actual survivors. They organized a survivors’ luncheon in Texas to discuss a radical new idea: Could survivors and people in treatment train for and participate in a triathlon? Back in Seattle, Gralow, who had already signed on as medical director for the local Danskin Triathlon, was all for it. Team Survivor Northwest had its start.

The best part is, the program is compassionately designed for all women. “You don’t have to be an active person to join in,” says breast cancer survivor Brenda Frost. She had just been laid off from work when she received her cancer diagnosis. The double whammy laid her low. Then, she found Team Survivor Northwest in the back pages of her patient resources notebook.

“I am not a ‘support group person,’” Frost says. “I chose the Run-Walk Half Marathon training program because it was about doing something.” The commitment to keep her promises to others was a motivator. “I knew I had to get up every day to meet people who were waiting for me,” she recalls. These new friends helped Frost face the future. Walking four to six miles a day gave her a sense of control and a path toward getting healthy again. Now in her seventh year of remission, Frost just stepped down as board chair of Team Survivor Northwest.

Do not wait for an invitation

Vicky Grams was fortunate that her doctor understood the importance of exercise in increasing cancer survival and quality of life. But Gralow’s willingness to discuss exercise with Grams is an unfortunate rarity. According to the Bipartisan Policy Center, the “get-your-toosh-off-the-sofa” conversation only happens in about 13 percent of office visits. Not every provider feels confident to prescribe exercise, perhaps because, as a 2015 Oregon State University study found, exercise science is not required learning in most medical schools in the United States. So we need to be prepared to ask questions and advocate for ourselves. See the sidebars for resources on how to get started.

Coach Lisa Stuebing is a recognized leader in older adult fitness. As a medical exercise specialist, her emphasis is in brain health, chronic pain management, and movement disorders. In addition to seeing private clients in their homes, she teaches for the Brain Injury Alliance of Washington and gives talks on behalf of both the Arthritis Foundation and the American Heart Association | American Stroke Association. Contact her at CoachLisa@MudPuddleFitness.com.

How to find help and training

Your exercise program should be highly personalized. To find a medical exercise specialist or appropriate group exercise option, check with your treatment center’s health education department or social worker. They may refer you to a larger organization, such as Cancer Pathways, Cancer Lifeline, or Team Survivor Northwest.

If you are hiring a personal trainer, ask which certification they hold. There are several solid specialty courses including those offered by ACSM, ACE, ISSA, NFPT, Healthy Steps (formerly knowns as the Lebed Method), and the Cancer Training Institute.

Anyone who works with you should take a complete health history including how your cancer was treated and the medications that you currently take. Some side effects may show up well after treatment has ended.

Fundraising walks often provide training for survivors. Walks are held year-round and one may be coming to a community near you. Search online for events including Relay for Life (American Cancer Society), Susan G. Komen events (including Race for the Cure), and the Leukemia & Lymphoma Society (Light the Night).

Simple steps to get started

Take your first step today. Enlist at least one member of your care team to take a walk with you tomorrow. Make arrangements for the day after tomorrow, too. Not big on small talk? Walk with your dog (or borrow one).

Minutes count. If you can walk 10 minutes today, mark that on your calendar. Next week, go for 15 minutes. Always treat yourself to a nice stretch at the conclusion of your walk. Begin by taking a dramatic yawn, reaching both arms up and out and down. Then, resting your forearms on the back of a chair, step backward until you are a table with your back parallel to the floor. Finally, sit in your favorite chair and stretch out your right leg, flexing the toe toward you. Repeat with the left leg.

Your ultimate goal is 150 minutes of moderate cardio and two strength training sessions per week. The good news is you don’t have to be perfect. The British Journal of Cancer published a review of exercise effects in sedentary people living with and beyond cancer. They found that getting some exercise, some of the time, will make you measurably healthier in just eight to 12 weeks.

For most of my clients, pain prevents exercise. First comes the pain and then everything else follows. It is possible to manage chronic pain with movement — at least enough — to vitally enjoy life more.